Neck

Question 1

Translation from right to left of the cervical

spine causes

Answer 1

sidebending to the right

Question 2

Translation from left to right of the cervical

spine causes

Answer 2

sidebending to the left.

Question 3

Why soft tissue techniques should be slowly applied and slowly released

Answer 3

to prevent activation of the stretch reflex

Question 4

A quick stretch of the muscle

Answer 4

excites the muscle spindle, causing reflex contraction

Question 5

Soft Tissue Techniques are active or passive?

Answer 5

can be both

Question 6

Passive Soft Tissue Techniques

Answer 6

Performed by physician on a relaxed

patient

Question 7

Active soft tissue techniques

Answer 7

use the Golgi tendon reflex to cause relaxation in the

treated muscles - isometric resistance is used

Question 8

Golgi tendon reflex

Answer 8

Signals from Golgi tendon organ activated
by resisted contraction of the muscle results in
spinal reflex to inhibition motor neurons leading
to muscle relaxation and lengthening

Question 9

Still Technique steps

Answer 9

1. Guide the dysfunction into its freedoms
2. Next add a gentle compression
3. Maintain the compression for 3-5 seconds and
   then, while maintaining the compression, guide
   the dysfunction through neutral and into its
   barriers.
4. Release the compression and reasses

Question 10

direction of vector for Still technique

Answer 10

vector directed toward your monitoring finger at the
articular pillar (not directly towards the feet)
until you feel it at your monitoring finger.

Question 11

Absolute Contraindications for HVLA Cervical spine

Answer 11

• Osteoporosis/Osteomyelitis/Fracture
• Cancer in the bone
• Any “hardware” in the joint or fusion of the joint
• History of vertebral artery thrombosis, ischemia, or
dissection
• Rheumatoid Arthritis/Downs – Weakness transverse ligament (alar ligament)

Question 12

Vertebrobasilar Artery system

Answer 12

• The vertebral arteries arise from the
subclavian arteries, then enter deep to the
transverse process of the level of the C6.
Or occasionally (in 7.5% of cases) at the
level of C7.
• They then proceed superiorly, in the
transverse foramen of each cervical
vertebra until C1.
• At the C1 level, the vertebral arteries travel
across the posterior arch of the atlas
before entering the foramen magnum.
• Inside the skull, the two vertebral arteries
join up to form the basilar artery.

Question 13

Sign and symptoms of vertebrobasilar artery problems

Answer 13

• Malaise and nausea
• Vomiting
• Dizziness/Vertigo
• Lightheadedness
• Disorientation
• Unsteadiness in
walking
• Visual disturbances
• Severe headaches
• Weakness in
extremities
• Sensory changes in
face or body
• Dysarthria (difficulty
with speech)
• Dysphagia
• Hearing difficulties
• Facial paralysis

Question 14

Cervical Spine HVLA steps

Answer 14

• Always do Soft Tissue first
• Contact the posterior articular pillar with your
MCP joint and allow of slight extension over your
monitoring finger.
• Gentle cup the patient’s chin and support the
head with your opposite forearm or hand.
• Sidebend the patient’s head over your MCP joint.
• Rotate the head toward the barrier till you feel a
barrier to rotation “lock out”.
• Exert a rapid, short rotary thrust over your MCP
joint.
** Make sure to keep the head in the midline at all times.
**If the technique causes any dizziness, lightheadedness, or pain during the set up do not
perform the thrust.

Question 15

The direction of Force for cervical HVLA

Answer 15

– C2-3 – towards the
patient cheek
– C4-5 – directly across
– C6-7 – down towards the
patient’s shoulder